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IU - SPEA-H 411 - Study Guide - Final

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IU - SPEA-H 411 - Study Guide - Final

School: Indiana University
Department: OTHER
Course: Chronic & Long-Term Care Administration
Professor: Jaima Eisenhauer
Term: Spring 2018
Tags: longterm-care, LTC, Healthcare, Administration, and H411
Name: H411 LTC Exam 4 Study Guide
Description: Study guide for the upcoming Exam 4 covering lecture slide notes.
Uploaded: 03/20/2018
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background image H411 Long-Term Care Administration 
Exam 4 Review
Exam Specifics:  All MC & T/F  Chapters 7, 8, 10 Chapter 7: Organization, Environment, & Culture Change *Introduction*
~ Old Model ~ 
Health policy promoted nursing home environments patterned after hospitals o Followed hospital-based model – all about clinical care  ~ 1980 and Beyond ~  Emphasis on residential and aesthetic features was triggered mainly by market 
competition
o Attract private-pay patients 
o Homelike living emphasized 
o Clinical needs are addressed while improving quality of care and 
quality of life  Philosophy of Care  Traditional treatment philosophy = Parson’s Sick-Role Model  Institutional orientation 
o Patient relinquishes individual control 
o Four outcomes:
1. Rigid daily routines
2. Social distance
3. Depersonalization
4. Blocking routines
Person-Centered Care  o 3 Main Principles  Holistic environment  1. Socio-residential component emphasizes amenities, privacy, and  opportunities for individual interests to be balanced with social 
interaction and engagement
2. Highly individualized clinical care that incorporates evidence-based  practices 3. Overarching human factors  o Control is shared b/w patient & caregiver  Patient’s autonomy & decision making are enhanced  o Equal weight: Quality of LIFE & CARE  Challenges to Full Integration Primacy of Clinical Care  o Facility’s primary duty 
o Sick role cannot be dispensed with entirely 
Economic Necessity  o Facilities must function efficiently 
o Provide care to a large # of patient 
background image Patient-Related Constraints o Behavioral issues 
o Patient’s own condition limits choice and decision making – i.e. dementia 
patient  Regulatory Burden  o Paranoia of the regulatory system 
o Industry has been slow to respond to client wants 
Conflicting Rights  o Perfect integration of clinical, socio-residential, and human factors is almost  impossible  Balance & compromise become necessary o What each resident wants may conflict with what other residents may want  I.e. Yelling noise and combativeness by some disrupt the quality of life 
for others 
Clinical Set-Up
~
 Traditional clinical set-up in the majority of nursing homes 
Nursing Unit & Nursing Station  Central location 
Nurse call system, medical record, pharmaceutical rooms, etc. 
~ Nursing Units ~ self-contained wing or section of a facility Nursing station, bathing rooms, dining rooms, lounges, linen closets, soiled-utility 
areas
Odor control: enclosed soiled-utility, ventilation, waste elimination, sanitation. No 
chemical deodorizers
Segregating patients based on clinical criteria is not always practical Separate specialized care units are common for subacute and Alzheimer’s care ~ Nursing Station ~ hub of clinical care  Centrally located to serve nursing unit  Located to provide adequate supervision  Socio-Residential Environment  Healing Environment  Promotes adjustment Relieves pressures on clinical component Promotes social compatibilities ~ 2 Main Domains ~  o Personal Domain   Security: Physical, psychological, freedom of risk, danger & anxiety  Safety: life safety codes, fall prevention, hazards  Wayfinding: “disorientation can come from sameness” – use signage, 
different color, etc. 
Autonomy: self-determination, independence, choice and action  Privacy (Space, Time, & Person)  o Public Domain   Compatibility: room sharing, bonding, etc.  Dining: make enjoyable, seating arrangements, etc.  Socializing: scheduled programs must offer numerous opportunities  Modern Architectural Designs  Small private rooms  Elimination of long corridors 
background image Neighborhood living arrangements  High-pitched roofs and fireplaces in lounges  Connection of indoor and outdoor spaces  Eliminate/conceal nursing stations  ~ “Nested Single-Room Design ~ special design that enables small private rooms to 
be “nested” to conserve space and construction cost 
Aesthetics ~ necessary for promoting wellbeing – sleep, comfort, mental – emotional-
physical – and social behaviors
Lighting ~ inadequate lighting can lead to depression & falls  25-50% HIGHER for 
seniors 
Raise light levels substantially  Balance natural and electric light  Eliminate glare   Natural sunlight is good for health  Color ~ Pleasing and stimulating colors Can be used for wayfinding & promote safety  Noise ~ Noise levels in US nursing homes were found to be in range of 50-70 dBs… Recommended levels: BELOW 45 dB during Day   BELOW 35 dB at Night  Noise Reduction  Acoustical ceiling and wall products; sound proofing resident 
rooms
o Lined drapes, wall-hung quilts, sound absorbing panels, place mats on dining tables, rubber tips under tables and chairs, limiting overhead paging, 
restricting use of cell phones, closing doors
~ Furnishings ~ carpeting adds warmth  Carpeting can cushion falls Moisture barriers & antimicrobial coating  o Not appropriate for all areas  Slip-resistant tile  Resilient flooring & soft-surface flooring  Coated upholstered furniture  ~ Enriched Environments ~  Bio philia  Human tendencies are to affiliation with nature  o Indoor & Outdoor 
o Plants, animals, water, and soil 
o Positive mood and mental restoration as well as physical benefits 
Theory of Thriving  living life to the fullest  o 3 Entities: person, human environment, nonhuman environment 
o Engaging, supportive & harmonious relationships b/w the 3 entities enhance 
well-being  o Discordance results in failure to thrive  Principles of Enrichment  To create an enriched environment:  3 elements of person-centered care must be integrated  Moderate degree of positive stimulation & distraction Includes opportunities for solitude, introspection, spiritual contemplation, and 
study 
o As well as active engagement in meaningful relationships  (Allows for alone time and socialization)
background image Culture Change  gradual transformation of the traditional nursing home environments
and care processes driven by the sick-role model to the ones that promote person-
centered care in enriched environments.
Affects residents, direct care staff, management & physical environment  ~ Achieved by blending ~  1. Integration of 3 elements of person-centered care 
2. Creation of enriched environment 
3. Decentralized management & empowerment of associates 
o Consistent assignment is recommended  The Pioneer Network  Formal organization that has evolved into a growing national movement  o Advocates culture change 
o Provides education & advocacy to influence public policy 
o State Government & CMS have endorsed the principles of culture change 
Methods of Culture Change  No single model – varies by facility, etc. 
~ Contemporary Models ~ 
Eden Alternative  o Therapeutic values of pets and humans, opportunities to care for others, and  spontaneity o Banish loneliness, helplessness, and boredom  Green House Project  o Small group environment: freestanding cottages 
o Ceiling transfer lifts 
o Natural outdoor activities emphasized 
o Cross-trained associates give care, cook, and clean 
Dementia Patients: Environment  Small groupings – small-scale living  Moderate stimulation from environment  Stressors lead to dysfunctional behaviors  Unpleasant sounds, intense lighting, bold colors, etc.  Protect pathways for wandering  Nature-related activities and pet therapy  Chapter 8: Social Services, Admission, & Discharge  Good nursing home social work deals effectively with residents’ psychosocial 
concerns 
Psychosocial  various social and emotional needs and the care provided to meet
those needs 
Unaddressed needs can lead to depression, anxiety, and physical illness  Social Services 
Focus of social work is on supporting the coping and adaptive capabilities 
The social worker performs key planning and coordinating activities from 
preadmission through a patient’s stay in the facility to the time of 
discharge

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School: Indiana University
Department: OTHER
Course: Chronic & Long-Term Care Administration
Professor: Jaima Eisenhauer
Term: Spring 2018
Tags: longterm-care, LTC, Healthcare, Administration, and H411
Name: H411 LTC Exam 4 Study Guide
Description: Study guide for the upcoming Exam 4 covering lecture slide notes.
Uploaded: 03/20/2018
13 Pages 50 Views 40 Unlocks
  • Better Grades Guarantee
  • 24/7 Homework help
  • Notes, Study Guides, Flashcards + More!
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